Challenges in Management of Rhegmatogenous Retinal Detachment in a Patient With Wilson’s Disease: A Case Report and Literature Review

Abstract

Wilson's disease (WD) is a rare hepatolenticular inherited disorder affecting copper transport resulting in accumulation of copper, which leads to the induction of apoptosis in different organs. Furthermore, patients with WD have elevated cytokines activity responsible for inflammation of various tissues. Here, we report our challenges in managing a case of rhegmatogenous retinal detachment (RRD) in a oneeyed 28-year-old male with WD who had a previous history of severe intraocular inflammation that ended with phthisis bulbi after pars plana vitrectomy for RRD. After one year, he developed RRD in the seeing eye. A decision was made to perform scleral buckling to avoid the risk of postoperative intraocular inflammation. However, a barrage laser was required for shallow retinal detachment in a subsequent follow-up, which was ultimately complicated by severe intraocular inflammation. We observed that our patient with WD had a tendency for severe intraocular inflammation, even following minor non-surgical ophthalmic procedures. For this reason, ophthalmologists need to be aware of managing similar cases and perhaps other diseases associated with elevated levels of cytokines.

Corneal pyogenic granuloma in a patient with keratoconus after the application of tissue adhesive for a perforated corneal ulcer

“…The use of 0.5% timolol eye drops is another promising conservative treatment option. A report on conjunctival pyogenic granuloma following strabismus surgery in a 13-year-old Egyptian girl showed regression after treatment with 0.5% timolol eye drops when topical steroid therapy had failed 9…”

Eye Involvement in Wilson’s Disease: A Review of the Literature

“…Other ophthalmological involvements have been described, essentially in case reports: night blindness, exotropic strabismus, optic neuritis, optic disc pallor, rhegmatogenous retinal detachment, loss of accommodation response, and eyelid opening apraxia [7,56,57]. In fact, few case reports have described the association between WD and optic neuropathy with optic disc pallor.…”